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https://www.readbyqxmd.com/read/29141482/obstetric-practice-guidelines-labor-s-love-lost
#1
Wayne R Cohen, Emanuel A Friedman
Implementation of clinical practice guidelines may moderate health care costs, improve care, reduce medicolegal liability, and provide a uniformity in care allowing meaningful investigation of treatments and outcomes. However, new guidelines are often uncritically embraced by clinicians, risk management organizations, insurance companies, and the courts as the standard of care. Adoption of incompletely vetted recommendations can lead to patient harm. Recent recommendations made by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine for assessment and management of labor provide an example of well-intended guidelines adopted uncritically...
November 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29078948/quality-improvement-and-patient-safety-on-labor-and-delivery
#2
REVIEW
Bethany Sabol, Aaron B Caughey
There has been an emphasis on redesigning our health care system to eliminate medical errors and create a culture of safety. The American College of Obstetrics and Gynecologists defines a culture of safety as an environment in which all care providers are empowered to identify errors, near misses, risky behaviors and broader systems issues while engaging in active collaboration to improve and resolve processes and system failures. This article reviews key components that promote a culture of safety and help to implement safer, more effective, evidence-based quality care on labor and delivery units...
December 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29078938/defining-and-managing-normal-and-abnormal-second-stage-of-labor
#3
REVIEW
Yvonne W Cheng, Aaron B Caughey
The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 49 on Dystocia and Augmentation of Labor defines a prolonged second stage as more than 2 hours without or 3 hours with epidural analgesia in nulliparous women, and 1 hour without, or 2 hours with epidural in multiparous women. This definition diagnoses 10% to 14% of nulliparous and 3% to 3.5% of multiparous women as having a prolonged second stage. Although current labor norms remained largely based on data established by Friedman in the 1950s, modern obstetric population and practice have evolved with time...
December 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29059453/what-s-new-in-prenatal-genetics-a-review-of-current-recommendations-and-guidelines
#4
Annalisa L Post, Amy T Mottola, Jeffrey A Kuller
Importance: The rapid development of prenatal genetic testing and screening tools and choices constantly challenges clinicians to stay up to date on current best practice. Objective: We sought to review, compare, and summarize recent national society guidelines on prepregnancy genetic screening and prenatal diagnosis for aneuploidy with a focus on changes and additions to previous guidelines. Evidence Acquisition: We performed a descriptive review of 8 recently published (2016-2017) national guidelines and updates on prenatal genetic screening and testing including American Congress of Obstetricians and Gynecologists committee opinions and practice bulletins, Society for Maternal-Fetal Medicine consult series publications, and an American College of Medical Genetics and Genomics position statement...
October 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29016505/implementing-a-systematic-approach-to-reduce-cesarean-birth-rates-in-nulliparous-women
#5
Amy D Bell, Saju Joy, Susan Gullo, Robert Higgins, Eleanor Stevenson
OBJECTIVE: To implement a systematic approach to safely reduce nulliparous cesarean birth rates. METHODS: This is a quality improvement project at two rural community hospitals and one urban community hospital in North Carolina. These facilities implemented a systematic approach to reduce nulliparous cesarean birth rates, aligning with recommendations developed by the Council on Patient Safety in Women's Health Care: Patient Safety Bundle on the Safe Reduction of Primary Cesarean Births...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28983443/rowers-self-reported-behaviors-attitudes-and-safety-concerns-related-to-exercise-training-and-competition-during-pregnancy
#6
Ashley Franklin, Joanna Mishtal, Teresa Johnson, Judith Simms-Cendan
Background The American College of Obstetrics and Gynecology notes that pregnant athletes require more supervision due to their involvement in strenuous training schedules throughout pregnancy. Currently, rowing is not mentioned in the guidelines despite its increasing popularity, high cardiovascular demands, and risk for abdominal trauma. Methods This study aimed to elicit information from competitive female rowers regarding exercise, training, and competition during pregnancy. We administered a survey consisting of 122 items to female Masters rowers in the United States, aged 21 to 49 years, from June to December 2013...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28974300/the-treatment-of-illnesses-arising-in-pregnancy
#7
Michael Bolz, Sabine Körber, Toralf Reimer, Johannes Buchmann, Hans-Christof Schober, Volker Briese
BACKGROUND: The treatment of pregnant women who have illnesses unrelated to pregnancy can cause uncertainty among physicians. METHODS: We searched the PubMed database and specialty guidelines from Germany and abroad (the guidelines of the German Society for Gynecology and Obstetrics, the American Congress of Obstetri cians and Gynecologists, and the Royal College of Obstetricians and Gynaecologists) over the period 2007-2016 for information on standards for the diagnosis and treatment of five illnesses that can arise in pregnancy: bronchial asthma, migraine, hypothyroidism, hyperthyroidism, and varicose veins...
September 15, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28876321/provider-adherence-to-syphilis-testing-recommendations-for-women-delivering-a-stillbirth
#8
Chirag G Patel, Jill S Huppert, Guoyu Tao
OBJECTIVE: To assess overall adherence to Centers for Disease Control and Prevention and American College of Obstetrics and Gynecology recommended guidelines for syphilis testing among women who delivered a stillbirth and compare it with other tests recommended for stillbirth evaluation. METHODS: We used MarketScan claims data with 40 million commercially insured and 8 million Medicaid enrollees annually to estimate prenatal care and follow-up testing among women who had stillbirths between January 1, 2013, and December 24, 2013...
November 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28870169/determinants-of-physical-activity-frequency-and-provider-advice-during-pregnancy
#9
Eilann C Santo, Peter W Forbes, Emily Oken, Mandy B Belfort
BACKGROUND: Our aims were to (1) describe the frequency of physical activity and prenatal healthcare provider advice about physical activity during pregnancy and (2) examine determinants and correlates of 3rd trimester physical activity and receipt of physical activity advice. METHODS: We analyzed data from the 2008 Pregnancy Risk Assessment Monitoring System. We studied 2669 women from North Carolina and Colorado with data on physical activity frequency in the 3 months prior to pregnancy and during the 3rd trimester and 1584 women from Oklahoma with data on provider advice regarding physical activity during pregnancy...
September 5, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28859772/no-247-antibiotic-prophylaxis-in-obstetric-procedures
#10
Julie van Schalkwyk, Nancy Van Eyk
OBJECTIVE: To review the evidence and provide recommendations on antibiotic prophylaxis for obstetrical procedures. OUTCOMES: Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in obstetrical procedures. EVIDENCE: Published literature was retrieved through searches of Medline and The Cochrane Library on the topic of antibiotic prophylaxis in obstetrical procedures. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28811044/learning-how-to-teach-one-a-needs-assessment-of-the-state-of-faculty-development-within-the-consortium-of-the-american-college-of-surgeons-accredited-education-institutes
#11
John T Paige, Nehal N Khamis, Jeffrey B Cooper
BACKGROUND: Developing faculty competencies in curriculum development, teaching, and assessment using simulation is critical for the success of the Consortium of the American College of Surgeons Accredited Education Institutes program. The state of and needs for faculty development in the Accredited Education Institute community are unknown currently. The Faculty Development Committee of the Consortium of the Accredited Education Institutes conducted a survey of Accredited Education Institutes to ascertain what types of practices are used currently, with what frequency, and what needs are perceived for further programs and courses to guide the plan of action for the Faculty Development Committee...
November 2017: Surgery
https://www.readbyqxmd.com/read/28800668/-epidemiology-risk-factors-and-risk-stratification-of-venous-thromboembolism-in-pregnancy-and-the-puerperium
#12
Panagiotis Tsikouras, Georg-Friedrich von Tempelhoff, Werner Rath
Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28752015/survey-of-provider-preferences-regarding-the-route-of-misoprostol-for-induction-of-labor-at-term
#13
Rachel Towns, Sara K Quinney, Rebecca C Pierson, David M Haas
Objective  To survey obstetrical provider preferences regarding use of misoprostol for induction of labor (IOL). Methods  An anonymous 25-question survey was distributed at an American College of Obstetricians and Gynecologists (ACOG) joint District V and VII Meeting in 2014 to obstetrics providers. The same survey was sent electronically to local providers. A separate survey was emailed to the labor and delivery nurses at two of the teaching hospitals in Indianapolis. The surveys queried provider demographics, dosing practice for misoprostol, opinions regarding different dosing strategies, and instructions on buccal administration...
July 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28729106/no-223-content-of-a-complete-routine-second-trimester-obstetrical-ultrasound-examination-and-report
#14
Yvonne Cargill, Lucie Morin
OBJECTIVE: To review the benefits of and requirements for a complete second trimester ultrasound and the documentation needed. OUTCOMES: A complete second trimester ultrasound provides information about the number of fetuses, the gestational age, the location of the placenta, and fetal and maternal anatomy. EVIDENCE: In the production of this document, the American Institute of Ultrasound in Medicine's "Practice Guideline for the Performance of Obstetric Ultrasound Examinations," the American College of Obstetricians and Gynecologists' practice bulletin, "Ultrasound in Pregnancy," and the Royal College of Obstetricians and Gynaecologists' Working Party Report, "Ultrasound Screening" were reviewed...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28729105/n-o-223-tenue-syst%C3%A3-matique-d%C3%A2-un-examen-%C3%A3-chographique-obst%C3%A3-trical-au-cours-du-deuxi%C3%A3-me-trimestre-contenu-d%C3%A2-un-examen-et-d%C3%A2-un-rapport-exhaustifs
#15
Yvonne Cargill, Lucie Morin
OBJECTIF: Analyser les avantages d'un examen échographique exhaustif au cours du deuxième trimestre et les conditions nécessaires à sa tenue, ainsi que la documentation requise. ISSUES: Un examen échographique exhaustif au cours du deuxième trimestre offre des renseignements au sujet du nombre de fœtus, de l'âge gestationnel, de l'emplacement du placenta et de l'anatomie fœtale et maternelle. RéSULTATS: Dans le cadre de la rédaction du présent document, le document « Practice Guideline for the Performance of Obstetric Ultrasound Examinations » du American Institute of Ultrasound in Medicine, le bulletin de pratique « Ultrasound in Pregnancy » du American College of Obstetricians and Gynaecologists et le rapport de groupe de travail « Ultrasound Screening » du Royal College of Obstetricians and Gynaecologists ont été analysés...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28707101/the-use-of-acog-guidelines-perceived-contraindications-to-iud-and-implant-use-among-family-planning-providers
#16
Ash E Philliber, Heather Hirsch, Claire D Brindis, Rita Turner, Susan Philliber
Objectives The uptake and actual use of the current guidelines from the American College of Obstetrics and Gynecology (ACOG) is unknown. Methods Family planning providers across Colorado and Iowa were surveyed as part of statewide initiatives to reduce unintended pregnancy in 2010 and 2012, both before and after the release of the guidelines. These initiatives focused on the promotion of intrauterine devices (IUDs) and implants. These surveys included questions on providers' views regarding the suitability and safety of the copper T IUD, hormonal IUD, and single rod implant for various subgroups of clients...
September 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28644340/committee-opinion-no-708-improving-awareness-of-and-screening-for-health-risks-among-sex-workers
#17
(no author information available yet)
The population of women who sell or exchange sex or intimate sexual services for material goods or services, also called "sex work," often is unrecognized in the typical obstetric and gynecologic practice. The prevalence of this behavior among adult women is difficult to quantify because of its frequent omission from the routine sexual history by women and clinicians. Data on the prevalence of sex work in the United States are largely lacking. The American College of Obstetricians and Gynecologists supports increasing awareness about the health risks, preventive care needs, and limited health care services for female sex workers...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28644333/committee-opinion-no-708-summary-improving-awareness-of-and-screening-for-health-risks-among-sex-workers
#18
(no author information available yet)
The population of women who sell or exchange sex or intimate sexual services for material goods or services, also called "sex work," often is unrecognized in the typical obstetric and gynecologic practice. The prevalence of this behavior among adult women is difficult to quantify because of its frequent omission from the routine sexual history by women and clinicians. Data on the prevalence of sex work in the United States are largely lacking. The American College of Obstetricians and Gynecologists supports increasing awareness about the health risks, preventive care needs, and limited health care services for female sex workers...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28629247/obstetric-practice-patterns-in-pregnancies-complicated-by-fetal-trisomy-13-or-18
#19
Sarah K Dotters-Katz, Marcela C Smid, Cora Mcelwain, Jeffrey A Kuller, Jay Schulkin
PURPOSE: Describe practice patterns among obstetrician/gynecologists (OB/GYNs) when caring for women with pregnancy complicated by fetal trisomy 13 (T13) or 18 (T18) and compare these between maternal-fetal medicine (MFM) and non-MFM providers. MATERIALS AND METHODS: We conducted an electronic survey using the American College of Obstetricians and Gynecologists database. Using simple statistics, we describe demographics and practice patterns among respondents and compare those of MFM practitioners with non-MFM providers...
July 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28579865/adaptation-of-maternal-fetal-physiology-to-exercise-in-pregnancy-the-basis-of-guidelines-for-physical-activity-in-pregnancy
#20
REVIEW
Edward R Newton, Linda May
Only 50 years ago obstetric care providers and women had many concerns regarding whether exercise during pregnancy created a harmful competition for substrate resources between the fetus and the mother. Animal and human research in the past 50 years, which includes acute and chronic aerobic exercise during pregnancy, has a reassuring margin of safety throughout gestation in women. Maternal physiology adapts to pregnancy changes involving the cardiorespiratory and glucometabolic alterations. Due to these changes, pregnant women have slight differences in response to acute exercise sessions...
2017: Clinical Medicine Insights. Women's Health
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